Guideline management tools, such as Official Disability Guidelines (ODG), give a general overview of what a case should look like and, therefore, can only take a claims handler so far in their decision making process. The claims handler can use the ODG as a reference to identify a recommended course of action, but the claims handler must ultimately decide how to proceed in view of these recommendations and a treating physician's submitted plan, though the claims handler usually makes a referral based only on the rehabilitation order of the physician. As a result, the need for rehabilitation or continued care may be solely established by the physician, who initiates all subsequent requests. The physician's recommendations often ignore the established clinical guidelines in the ODG, which are widely accepted, but rarely acted upon, especially in the workers compensation industry. The claims handler then perpetuates a claim based on subjective criteria, thereby driving costs up and eliminating the ability to deliver a positive clinical outcome.